Endoscope an essential instrument for every retina surgeon

Optimal visualization of the posterior segment is essential in all forms of retinal and vitreous surgical procedures. It becomes even more important when media opacities degrade the view of the retina and vitreous due to corneal scarring, altered anterior segment with significant scarring, lenticular clouding due to dense cataracts, or the presence of blood from hyphema or vitreous hemorrhage. In these and other situations, the use of an endoscope provides a view of the posterior segment to allow surgical evaluations and procedures to be performed despite these media opacities. Additionally, the endoscope permits visualization of anteriorly located structures, including the ciliary body and the sub-iris space.Historically, Thorpe first introduced endoscopy in ophthalmology in 1934. In 1978, endoscopy evolved to an instrument with a 13- to 14-gauge shaft, followed by a 20-gauge probe in 1990. Also by 1990, Volkov and colleagues introduced flexible endoscopes. The next step was the use of laser via the endoscope. Currently, a 23-gauge endoscopy probe with laser capability is available for use in various disease states involving the posterior segment of the eye. While the 19.5-gauge probe with a high-resolution camera offers up to 17,000 pixels and 140° of view, the 23-gauge probe drops the resolution to 6,000 pixels with a reduced field of view of 90° and requires a 330 W xenon light source for optimal viewing. Thus, over the last several decades, endoscopy has emerged as a useful technology in vitreoretinal surgery.